Xie Sifang, Zhang Jintao, Qin Yangda, Li Min, Lan Guiping, Wang Yongli, Huang Bo, Weng Jingjin, Wei Jiazhang, Qu Shenhong
Guangxi Medical University,Nanning,530021,China.
Department of Otolaryngology Head and Neck Surgery,the People's Hospital of Guangxi Zhuang Autonomous Region.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2024 Jun;38(6):514-517. doi: 10.13201/j.issn.2096-7993.2024.06.011.
To analyze the clinical features, treatment methods and prognosis of radiation-induced sarcoma(RIS) of the head and neck after radiotherapy for nasopharyngeal carcinoma(NPC), and explore its treatment strategies. A retrospective analysis was conducted on RIS patients after radiotherapy for NPC in the People's Hospital of Guangxi Zhuang Autonomous Region from January 2013 to October 2022. The time of onset, lesion location, pathological subtypes, imaging features and treatment outcomes were described, and the median survival time was statistically analyzed through follow-up. This study included 10 patients with an interval of 2-27 years between NPC and RIS. The nasopharynx was the more common site of RIS, and osteosarcoma was the main pathological type. The median overall survival was 18 months. The median survival was 40 months in the surgery combined with the chemotherapy group, and 12 months in the surgery alone group. The 1-and 2-year cumulative survival rates were 48% and 36%, respectively. Prognostic analysis showed that gender, age of onset, time of sarcoma onset after radiotherapy and treatment methods might not be influencing factors for prognosis, and osteosarcomas presented a poorer prognosis than other pathological types. RIS is one of the most severe long-term adverse effects in patients with NPC. The prognosis of RIS is poor, and complete surgical resection of the tumor can improve patient survival rates. In cases where complete surgical resection is challenging, radiotherapy or chemotherapy may offer some improvement in tumor control.
分析鼻咽癌(NPC)放疗后头颈部放射性肉瘤(RIS)的临床特征、治疗方法及预后,并探讨其治疗策略。对2013年1月至2022年10月在广西壮族自治区人民医院接受NPC放疗后的RIS患者进行回顾性分析。描述发病时间、病变部位、病理亚型、影像学特征及治疗结果,并通过随访对中位生存时间进行统计学分析。本研究纳入10例NPC与RIS间隔时间为2至27年的患者。RIS较常见于鼻咽部,骨肉瘤为主要病理类型。中位总生存期为18个月。手术联合化疗组中位生存期为40个月,单纯手术组为12个月。1年和2年累积生存率分别为48%和36%。预后分析显示,性别、发病年龄、放疗后肉瘤发病时间及治疗方法可能不是预后的影响因素,骨肉瘤的预后比其他病理类型差。RIS是NPC患者最严重的长期不良反应之一。RIS预后较差,肿瘤完整手术切除可提高患者生存率。在完整手术切除有挑战的情况下,放疗或化疗可能在肿瘤控制方面有一定改善。